In a normal knee, the groove on the femur for the patella is laterally displaced with respect to the mid-point of the femur, this lateral displacement being of the order of 5 mm. In addition to being laterally displaced, the patella groove on the femur is laterally angulated by 7° with respect to the distal femur and knee joint.
In the normal knee therefore as it flexes, the patella articulates in the patella groove on the femur. Clearly it is thus important in knee replacement design to reproduce the natural position of the patella groove on the prosthetic femoral component. This is not presently reliably reproduced in many knee replacement designs, and lateral patella maltracking is a common cause of pain and morbidity. In one known design, part of the lateral femoral condyle prosthesis is removed to accommodate such lateral displacement of the groove. This is undesirable in producing a reduced area of contact between the lateral femoral condyle and the polyethylene articulating surface, with the potential for increased plastics wear.
In another known design the long axis of the femoral condyles is at right angles to the transverse axis of the knee joint. When the knee is extended, the patella articulates at the front of the femoral component. Since this area is not required for the tibia-femoral articulation, then metal can be removed to provide a lateral angulation to the patella groove. However, when the knee is flexed, the patella groove is the general area between the medial and lateral femoral condyles, and these condyles are involved in the tibia-femoral articulation in extension. Any attempt by a designer to angulate the patella groove will have serious detrimental effects. The more the patella groove is angulated and displaced, the more the area of articulation for the lateral femoral condyle is reduced.
In GB2387546B the Applicant proposed a new design of knee prosthesis to address the problems with the above. This design includes a mobile bearing component between the femoral and tibial components, the bearing component having respective surfaces shaped to match the femoral condyles and engage therewith both when the knee is extended and also over a range of flexion. The condyles are in the form of respective parts of a common helix and the respective matching surfaces of the bearing component are correspondingly part-helical. Although this design represents an improvement over the above and provides a high level of congruity at the femoro-meniscal joint, the design also requires that the bearing component is mobile with respect to the tibial component so as to allow for rotation of the knee and this can have attendant drawbacks in terms of complexity of design and surgical implantation as well as cost.
An object of the present invention is therefore to provide an improved knee prosthesis which reduces or obviates the disadvantages of the prior art referred to.